PONE-D-24-16712Top-funded digital health companies offering lifestyle interventions for dementia prevention: Company overview and evidence analysisPLOS ONE

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2. Thank you for stating the following in the Competing Interests section: “RV, PH, TK, and MN are affiliated with the Centre for Digital Health Interventions (CDHI), a joint initiative of the Institute for Implementation Science in Health Care, University of Zurich, the Department of Management, Technology, and Economics at the ETH Zurich, and the institute of Technology Management and School of Medicine at the University of St. Gallen. CDHI is funded in part by CSS, a Swiss health insurer, Mavie Next, an Austrian healthcare provider and MTIP, a Swiss investor company. TK is also a co-founder of Pathmate Technologies, a university spin-off company that creates and delivers digital clinical pathways. However, neither CSS nor Pathmate Technologies, Mavie Next, or MTIP was involved in this research. All other authors declare no conflict of interest.”

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Reviewer #1: Partly

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: No

Reviewer #2: Yes

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5. Review Comments to the Author

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Reviewer #1: • More clarification of the term “invisible second patients” needed.

• No effective treatment for dementia management is available? (Cite the specific literature, if available, for this particular statement. There are so many pharmacological and non-pharmacological approaches to manage dementia)

• Methodology section is too limited. More clear explanation is needed.

• In Table No.1 the founding year of each company could have been arranged sequentially.

• From line 261-263 along with level try to provide the category name like – level 1 – good, level 2 – fair and so on.

• 268 – it is commonly known to everyone that, people with old age suffer from cognitive impairment (dementia). The outcome(s) of the review should be novel.

• 319- The lack of publication may be due to the young age of the companies. Can personal assumption be made in a systemic review or in any kind of scientific review???

• The paper somewhere failed to highlight the digital initiative in managing dementia or reducing the risk of dementia. Moreover, the improvements were just mentioned in a column under the heading “Change in Proxy”.

• The advantage of digital management as compared to in-person cognitive training could have been mentioned. Moreover, even the benefits of DHI’s and how it challenged the existing paradigms remain unclear.

• Research evidences pertaining to this topic are scarce, still the current paper claims to fill the existing literature gap.

• The sole aim of the paper somewhere got lost. The paper has lost its track from its central objective. Unnecessary details have been mentioned.

• Finally, the scope of the review was found to be scant.

Reviewer #2: PLOS One Manuscript review 08/09/24

Top-funded digital health companies offering lifestyle interventions for dementia prevention

Suggestion: Major revisions

Major comments

Line 133 Data was collected up to January 2023. Consider updating the search to include the last 20 months?

Line 176 The exclusion of non-risk groups (healthy individuals) seems to contradict the focus on prevention. Surely the target prevention population is dementia-free individuals?

Minor comments

Line 36 “Lack of disease modifying treatments” is no longer accurate. Suggest rewording.

Line 52 The conclusion is quite vague and lacks specific direction, suggest rewording to make clear what the added value of this study is.

Line 57 Avoid using the term “suffer” to refer to people living with dementia.

Make clear what is meant by dementia. Alzheimer’s disease? Or all-cause dementia syndromes? Those with a clinical diagnosis? Pathology?

Line 74 “Lack of effective treatments” no longer accurate.

Line 76 make clear what stage of life is being referred to when you talk about lifestyle. The potential impact of lifestyle changes is not constant across the lifespan.

Line 78 Cognitive training is not a well established modifiable risk factor for dementia, so it seems a little odd to include this here, particularly when other risk factors with better evidence are not mentioned.

The phrase ‘directly influence’ is problematic as the evidence is largely not causal and many interacting factors are involved.

Reference 10 is out of date, suggest replacing with an updated figure from more recent research.

Line 98 Suggest specifying ‘published’ clinical evidence – as you’ve not reviewed clinical evidence outside of the academic literature.

Line 99 I didn’t follow this. What is being continuously peer reviewed?

Line 104 Was the Google search systematic? What was the reason to do this?

Line 110 Search terms seem very limited. E.g were Alzheimer*, brain health etc not considered?

Line 121 The abstract suggests this study identifies companies globally, however the method section here excluded solutions not written in English. Surely this will limit the ability to accurately capture relevant solutions globally? Suggest removing the global claims given the methodology, and acknowledging this limitation in the discussion section.

Line 145 Please outline all reasons for exclusion with the number excluded for each reason. A flowchart may be helpful to illustrate how you reached the final analytical sample from the initial pool.

Line 166 The reliance on the company/ solution name being included in the publication is a limitation of this study which should be acknowledged in the limitations section. The company or solution name will not necessarily be included if the study was conducted by an academic partner, or prior to the solution being marketed. Also please state in the methods whether the company/solution name searched across the title/ abtract? Or author list as well?

As company websites were reviewed, did you consider contacting the companies to ask for signposting to their clinical evidence?

Line 171 Again, dementia seems rather limited as a search term on it’s own.

Line 174 – Why refer to access to care here? How is this related to prevention?

Line 221 Geographical analysis – I’m not sure what conclusions can be drawn from these results given the language restriction used in the methodology, as mentioned earlier.

Line 230 This whole paragraph seems to stray away from scientific results from the data collected. Suggest reducing rhetoric not related to the data, and saving interpretation for the discussion section.

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Reviewer #1: No

Reviewer #2: No

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Top-funded digital health companies offering lifestyle interventions for dementia prevention: Company overview and evidence analysis

PONE-D-24-16712R1

Dear Dr. Rasita Vinay,

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Kind regards,

Rocktotpal Konwarh, Ph.D.

Academic Editor

PLOS ONE